[Clinical application of expanded radical operation with improved Whipple technique to late pancreas head cancer]

Studies on the expanded eradicative and modified operation for treatment in patients of late pancreas head cancer, so as to enhance the incised rate, survival rate and life quality. Elective laparotomy was done in 20 patients. Expanded eradicative operation was performed in 18 patients (portal vein excision 19, left outer leaf of liver 8, transverse colon 3). We have reconstructed the portal vein 6, modified the Whipple operation, reconstructed the elementary tract using Roux-Y interposed jejunum with orientatied intussusception of artificial papilla. The incised rate of expanded eradication was 90% without postoperative serious complications such as biliary and pancreatic leakage, massive hemorrhage and operative death. The longest survival time was 5 years. The two-year survival rate was 50%. Statistical analysis (t test and x2) showed signithicant differences (P < 0.001).: (1) The exsion of original carcinomous focus may relieve the patient's symptoms and can prevent portal vein from carcinomous cell infiltration. (2) After enbloc incision with metastatic focus, sequential treatment could be given successfully.